However in cognitive behavioural therapy, the therapist helps the client learn to identify and correct erroneous beliefs and systematic distortions in information processing in the service of reducing distress and enhancing efforts to cope. Although there are several different variations of the approach, they all share the same characteristics. Clients are encouraged to treat their beliefs as hypotheses to be tested and are guided to do so in ways that protect against the biases and the distortions that preserve the idiosyncratic misconceptions inherent in each disorder.
In schizophrenia, cognitive behavioural therapy aims to increase an individual's understanding of psychotic disorders, develop coping strategies for persistent symptoms, foster self-belief and motivate clients to regulate their own behaviour. Clinical psychologists work on four areas: firstly, coping strategies that are aimed to reduce the distress of persistent psychotic symptoms by equipping the client with some coping strategies to manage their experiences of psychosis. Therapists work with clients to find patterns of when their symptoms occur for example, clients may hear voices when out shopping. Clients are encouraged to question their thinking perhaps by looking at rational alternatives to paranoid ideation and alter their behaviour perhaps by trying ways to distract attention from hallucinations, such as by reading out loud. Secondly, goal setting and overcoming hopelessness is to generate hope by highlighting worthwhile or short-term goals that may be achieved despite continuing disabilities. Thirdly the therapist tries to encourage the client to consider alternative interpretations for his or her delusional beliefs. To address this the therapist starts by trying to clarify their nature, perhaps by questioning about the origins or assumptions and how they affect the client's life.
Cognitive approaches are also used to cope with a range of obsessional compulsive disorders for example; a patient with obsessional anxieties about contamination by dirt may have his or her environment totally contaminated by the therapist in order to expose that person fully to obsessional stimuli and produce habitation of anxiety. Response prevention is used to encourage the patient not to carry out ritualistic behaviour in order that full exposure to the anxiety cues is achieved. Patients are also taught to distract themselves from upsetting thoughts. Rachman and Hodgson (1980) report a success rate between twenty to eighty percent for obsessional patients treated by this method.
The application of psychology to the fields of law and criminal behaviour has become
one the growth areas of applied psychology since the early 1980’s. In the UK the largest employer of forensic psychologists is HM prison service, which includes the home office research and developmental unit as well as prisons. However those with clinical and forensic training tend to work in psychiatric hospitals. In the civil law arena, forensic psychologists often provide assessments of whether someone has been harmed by some event. They might also assess the emotional injuries suffered by someone who has been injured in an accident or who witnessed a traumatic event. Psychologists are often called upon in sexual harassment suits to describe the impact of the harassment on the purported victim. In this arena, the forensic psychologist might be required to provide treatment recommendations or to analyze the specific treatment needs of an individual, and might be asked to determine the potential cost of such treatment.
They also provide courts with analysis relevant to questions of criminal insanity and trial competence. They help courts decide whether or not sex offenders are likely to re-offend or whether or not they are dangerous. They provide information and recommendations necessary for sentencing purposes, grants of probation, and the formulation of conditions of parole. Forensic psychologists are routinely called upon in death penalty cases to provide analysis of the intentions, motivations and personality characteristics of the accused. In the Juvenile Courts, they often are asked to help determine whether or not a youthful offender can be rehabilitated. They assist prosecutors, defenders, and law enforcement investigators in understanding a range of normal and criminal behaviors, sometimes serving as "criminal profilers."
Criminal profiling involves the forensic psychologist using their understanding of human behaviour, motivation, and pathology so that they can create a psychological profile of the offender. From observations of the crime scene one can infer the behavioural characteristics of the individual who created it. Profilers use their knowledge of whom the typical offender is that bears these characteristics and then predicts not only how the investigators can expect the offender to behave in the future, but also what their physical appearance will likely to be.
In the treatment of offenders forensic psychologists are responsible for the development of appropriate programmes for rehabilitation. Social and cognitive skills training is one of a number of cognitive behavioural programmes, which are all, based on how thoughts and attitudes affect behaviour. Many offenders are believed to be lacking in skills such as eye contact and turn taking in conversations, which is important for effective and social interactions to run smoothly. The programme assumes that being deficient in these skills is associated with offending and that acquiring such skills will reduce rates of re-offending.
Forensic psychologists also use anger management programmes, which is also a cognitive behavioural approach. Towl (1993, 1995) suggested that its aims was to teach individuals how to apply self control in order to reduce interpersonal anger with the long term goal of reducing disruptive behaviour. A recent study conducted by forensic psychologist, Holbrook (2001) used anger management successfully with a group of prison inmates. The male inmates selected for the programme had a history of aggression. The results showed a reduction in scores on a measure of vengeance, which is the tendency to take revenge.
In conclusion, just like clinical psychology, forensic psychologists are also interested in assessing and treating people with some form of mental illness. The difference is that forensic psychologists are also assessing the people being treated because they are somehow involved in the criminal justice system, mainly because of conviction for some offence. It seems reasonable to conclude that the cognitive approach has now become the dominant force in clinical psychology. Cognitive therapies have shown to be effective in reducing symptoms for a wide range of disorders. However it is clear from the work currently undertaken by forensic psychologists that their contribution to the legal and crime detection process can be quite valuable. Techniques such as offender profiling may assist in the apprehension of criminals but only if those techniques are reliable and based on empirical research. This essay has illustrated some of the areas in clinical and forensic psychology, the fields are rich in psychological theory and research continues to be applied across clinical and criminological fields.
References
Brewin, C.R. (1988). Cognitive Foundations of Clinical Psychology. Hove: Lawrence Erlbaum.
Colman, A. M. (1995). Applications of Psychology. London: Longman.
Cooligan, H. (1996). Applied Psychology. London: Hodder & Stoughton.
Hollin, C.R. (1989). Psychology and Crime: An Introduction to Criminological Psychology. London: Routledge.
Kuipers E. The management of difficult to treat patients with schizophrenia, using non-drug therapies. Br J Psychiatry Suppl. 1996 Dec;(31): 41-51
